After no reported human cases of highly pathogenic avian influenza (HPAI) H7N9 for over a year, a case with severe disease occurred in late March 2019. Among HPAI H7N9 viral sequences, those recovered from the case and from environmental samples of a poultry slaughtering stall near their home formed a distinct clade from 2017 viral sequences. Several mutations possibly associated to antigenic drift occurred in the haemagglutinin gene, potentially warranting update of H7N9 vaccine strains.

The 2014 – 2015 highly pathogenic avian influenza (HPAI) H5NX outbreak represents the largest and most expensive HPAI outbreak in the United States to date. Despite extensive traditional and molecular epidemiological studies, factors associated with the spread of HPAI among midwestern poultry premises remain unclear.

To better understand the dynamics of this outbreak, 182 full genome HPAI H5N2 sequences isolated from commercial layer chicken and turkey production premises were analyzed using evolutionary models modified to incorporate epidemiological and geographic information. Epidemiological compartmental models constructed in a phylogenetic framework provided evidence that poultry type acted as a barrier to the transmission of virus among midwestern poultry farms.

Furthermore, after initial introduction, a continuous external source of virus was not needed to explain the propagation of HPAI cases within the commercial poultry industries. Discrete trait diffusion models indicated that within state viral transitions occurred more frequently than inter-state transitions. Distance, road density and proportion of water coverage were all supported as associated with viral transition between county groups (Bayes Factor > 3.0).

Together these findings indicate that the midwestern poultry industries were not a single homogenous population, but rather, the outbreak was shaped by poultry sectors and geographic factors.

May 12, 2019

The Epidemiology and Disease Control Division says it is preparing to send specimens collected from the people who came in close contact with the person who died after contracting the H5N1 (bird flu) virus on March 29.

The division, under the Department of Health Services, had formed a team of medical doctors and lab technicians to carry out an epidemiological investigation after the death of a 21-year-old from Kavrepalanchok district from the bird flu virus.

“We have collected specimens from doctors, nurses, close family members, relatives, and hospitals--and also from homes,” Dr Bibek Kumar Lal, director at the division, told the Post.

The name of the deceased has not been disclosed yet, but he was said to be residing in Bhaktapur in a rented room and worked as a driver.

The Health Ministry, however, announced only on April 30 that the man had died from H5N1. Throat swabs of the deceased had been sent to the World Health Organisation’s Collaborating Centre for Influenza in Japan, which confirmed that he had contracted Influenza A (H5N1), which caused his death.

Following the confirmation of deadly virus responsible for the death, health experts from the WHO’s headquarters and its regional office in New Delhi, India arrived in Kathmandu to assist Nepali health officials to carry out an epidemiological investigation.

According to Lal, his office would send samples to the country recommended by the UN health agency.

Earlier, WHO officials suggested that specimens be sent to the Collaborating Center for Influenza in Japan that confirmed the virus. Such labs are in several countries and the UN health body may recommend any one of them.

“We are working closely with them and will decide our next step accordingly,” said Lal.

The division has secured all collected samples in the biosafety level-3 laboratory of the National Public Health Laboratory.

Health officials say it takes time to send samples to laboratories abroad, as manpower trained to handle the biohazard are required for that.

Airlines do not easily carry such specimens and for that, protocols of international health regulations need to be followed, according to officials at the Health Ministry.

Meanwhile, the ministry said it was still tracking some people, who came in contact with the deceased but are out of home for personal business.

The death of the 21-year-old from H5N1 virus, the first bird flu casualty in Nepal and first in the world since February 2017, has been a cause for concern. H5N1 is a lethal bird flu virus strain that is highly pathogenic.

May 10, 2019

The H5N1 influenza virus, commonly known as bird flu, has been detected among the chickens reared by a farmer at Madhyabindu Municipality in Nawalparasi (East). Dr Shyam Krishna Tiwari, chief of the municipal veterinary service unit, said bird flu virus was detected among the chickens belonging to Pitambar Mahato.

Mahato had taken the samples collected from his chickens to the National Avian Disease Investigation Laboratory in Chitwan for test after some 0f the fowls started dying in the coop.

The lab results confirmed that the chickens had contracted the avian flu, Dr Tiwari said. After the lab confirmed the bird flu virus, a joint team of technicians from Ministry of Land Management, Agriculture and Cooperative Management of Gandaki Province, Livestock Development Office, National Avian Disease Investigation Laboratory and the municipality was deployed to Mahato’s farm to cull the chickens. The team also destroyed the poultry and feeds belonging to Mahato’s neighbours.

The local administration has urged the local poultry farmers to stop rearing fowls until the bird flu comes under complete control.

The H5N1 bird flu virus that has been confirmed as the first cause of death in Nepal, 10 years after it was first detected in birds in 2009, is the world’s first H5N1 human infection since February 2017 and has raised issues of public health emergency of international concern as government and WHO officials refuse further information on the case.

“We are taking the help of the UN body to contain the disease,” Ministry of Health and Population spokesperson Mahendra Prasad Shrestha told the Post.

As experts from the World Health Organization headquarters and its Delhi office gather in the Capital to take stock of the situation, Shrestha says the government is taking the incident seriously and adhering to the standard protocols of international health regulations that Nepal is obligated to.

The deceased, a 21-year-old from Kavrepalanchok district, who had been residing in Bhaktapur and whose identity has not been revealed by the government, was first admitted to Nepal Medical College on March 24 after showing signs of fever and cough.

Doctors, who had then suspected influenza infection sent throat swab specimens to the National Public Health Laboratory on March 25. The same day, before the laboratory results were out, the patient was administered with Oseltamivir, an influenza antiviral medication taken from the Epidemiology and Disease Control Division. But the laboratory failed to identify the strain of the virus, the ministry said in a statement on Thursday.

The patient, who worked as a driver, was then transferred to Om Hospital as his condition became critical, according to one official who wanted to remain anonymous. Four days later, on March 29, the patient died due to respiratory complications while undergoing treatment.

Throat swab specimens were then sent to the WHO Collaborating Center for Influenza in Japan, according to the ministry and laboratory results received on April 30 tested positive for Influenza A (H5N1).

H5N1 is a lethal bird flu virus strain that is highly pathogenic. The first infection in humans was reported in 1997 in Hong Kong and the virus has since spread to Asia, Africa, Middle East and Europe and other parts of the world causing millions of poultry infections.

Although rare, confirmed human cases for bird flu as reported by the WHO from 2003 to April 9 this year stands at 860 human cases and 454 deaths. According to the UN body, almost all cases of H5N1 infection have been associated with close contact with infected live or dead fowls or contaminated environment.

For some reason I can't access the website of the Ministry of Health and Population (my location in Canada is "blacklisted"). But this appears to be a confirmed report, and I'll follow the story with interest.

April 22, 2019

Ten years ago, this blog was just about all H5N1, and I had a lot of news on cases in Indonesia, Egypt, and Pakistan. Then, on April 21, I posted an item by Helen Branswell, then with The Canadian Press: Branswell on the California swine-flu cases. Excerpt and then a comment:

U.S. public health authorities are investigating two cases of swine flu in unrelated children in California, a development that has officials in Canada and elsewhere on alert.

Discovery of the two cases, in children who apparently had no contact with pigs or with each other, suggests there probably has been some person-to-person spread of swine flu viruses, officials of the U.S. Centers for Disease Control said Tuesday.

Whether the viruses continue to spread isn't currently known.

"The investigation is not finished. It's ongoing. But of course not having that direct swine link does raise additional questions and does suggest that there may have been human-to-human transmission. And so it basically ratchets it (concern) up a bit," said Dr. Nancy Cox, head of the CDC's influenza division. "I think this is one of those situations where everyone will want to stay tuned."

U.S. officials notified the World Health Organization of the cases last Friday, as required under the International Health Regulations. That treaty stipulates that countries must notify the WHO when they see cases of infectious diseases that pose an international threat, such as novel subtypes of influenza with pandemic potential.

The next day saw a "swine flu" post from the much-missed Revere, Flublogia's resident grownup in those days. Although I didn't post it, the CDC also issued a notice about it on April 22, and on the 23rd the Globe and Mail warned that Canadians returning from Mexico should be alert to the symptoms of "Mexican flu."

What followed was not so much mission creep as mission drag, as a real live serious novel influenza hauled me and the rest of Flublogia out of our comfortable niche and into a much more complicated world. That drag continues.

Birdflu (H5N1) outbreak in Phuentsholing has been fully contained. The rapid response team is currently conducting active surveillance and border vigilance.

The outbreak was confirmed on April 8 at Dhamdara, a village at the outskirt of Phuentsholing proper. No human contact was reported.

About 14 households were affected. The response team culled about 1,130 birds, disposed of 3,955 eggs and 613kgs of commercial feeds.

Incident commander for incident operation centre, Dr Basant Sharma from the Regional Livestock Development Centre (RLDC) Tsimasham, said the team was visiting all households in Phuentsholing to collect samples from sick birds.

He said that the surveillance would continue for 20 more days.

The department of livestock, Chukha dzongkhag livestock sector, department of public health, Royal Bhutan Police, Bhutan Agriculture and Food Regulatory Authority and the Regional Livestock Development Centre RLDC and local authorities in Phuentsholing initiated the response to the H5NI outbreak jointly.

April 13, 2019

A bird flu (H5N1) outbreak has affected 13 poultry farms and one turkey farm at Dhamdara in Phuentsholing.

The outbreak was confirmed on April 8 through laboratory test from National Centre for Animal Health (NCAH), Serbithang, Thimphu.

No human contact was reported.

In response, a total of 1,130 poultry birds in the affected areas were culled, about 4,002 eggs disposed, 613kgs of feed disposed and 12 chicken coops destroyed.

The National Incident Command Committee (NICC) has activated the Incident Operation Centre (IOC) at Thromde Veterinary Hospital in Phuentsholing with the Rapid Response Team (RRT) from different ministries and agencies for immediate containment and response to the outbreak.

A press release from the ministry states, “As the disease is brought under control at the source of outbreak the public should not panic. The public is also advised to take precautions like washing of hands after handling poultry, chicken and eggs with soap and water.”

Program director of NCAH, Dr RB Gurung, the focal person of bird flu said the outbreak was reported in the field on April 6.

He said the outbreak is under control by about 80 percent yesterday. As the outbreak location was at the outskirt of town, there were not much vehicles plying, which made it easier, he added.

The response team also created awareness in the community. Vehicles plying out of the demarcated infected and restricted zone are also disinfected.

Dr RB Gurung said poultry farmers are cautioned to comply farm bio-security measures and not allow visitors into the farms without proper safety measures.

March 31, 2019

Cuttack: A team of veterinary doctors and experts culled more than 600 ducks and 66 chickens on Sunday following confirmation of bird flu (H5N1) in the city.

An outbreak of bird flu was suspected after death of ducks in the Duck Breeding Centre and Dairy Farm at Khapuria . On March 23, as many as 13 ducks died on the day in the farm. District veterinary office investigated into the incident and sent blood samples to National Institute of High Security Animal Diseases (NIHSAD) in Bhopal.

“Following the test report, we culled ducks and chickens. Moreover, 3.6 quintal of foodgrains were destroyed as well. Carcasses of culled birds were buried in 10-foot dip pits. Bleaching powder and other disinfectants were sprinkled while filling up the pits to prevent spread of H5N1 virus,” added Rout.

All the poultry farms in one-km radius of the breeding centre have been banned for the time being. The farms will remain closed for next six months according to guidelines, added Rout.